Post-cholecystectomy bile leak new classification and management

ABSTRACT

The aim of this prospective study was to identify the cases of bile leak and their subsequent management in view of the up-to-date Gouma classification. Twelve patients with bile leak and suspected biliary tract injury were included in the study [11 females and one male with a mean age of 46 years]. Ten patients underwent laparoscopic cholecystectomy and two patients had open cholecystectomy; they were subjected to history, clinical examination, liver function tests, ultrasound and ERCP. They were classified by Gouma 1998 into four groups [A, B, C and D] according to the type of the lesion. The study concluded that most of the patients with bile leak can be classified and managed successfully by ERCP and those who had concomitant bile duct injury that be treated surgically with Rou en Y biliary enteric bypass